We have access to some of the most amazing medical technology in the world, but technology alone is not the answer. You need a sustainable system. Our healthcare system does not work well in sparsely populated regions. Our rural hospitals are closing at an alarming rate. And efforts that may increase the numbers of uninsured patients are likely to accelerate this effort. Patients will show up in emergency departments, and will have to be treated at the hospital’s expense. We need more options that will give people affordable access to non-acute healthcare services. Hospitals have enormous overhead, making individual services expensive. The $100 aspirin doesn’t cost $100, but when you parcel out all the physical plant, employee, compliance, and insurance costs, it rapidly gets expensive. Having other, leaner options available with less overhead will help keep costs down. As a nation, we seem take the attitude that if we make unhealthy choices, someone can fix it for us. We need to continue the shift to a “wellness” attitude, with feedback systems that reward individuals and healthcare systems for helping people to be healthy, rather than wait to “fix” them when they get sick.
Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Alfred Poor, PhD, is the Health Tech Futurist. A technology speaker and writer with an international reputation, he is the Editor of Health Tech Insider (https://healthtechinsider.com), a website and newsletter that covers wearable and mobile devices for health and medical applications, as well as supporting technologies. A graduate of Harvard College, he is the author or co-author of more than a dozen books.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
After six years of working in schools, I found that personal computers could automate some of my tasks. I started a computer consulting firm, and soon landed paid writing assignments about computers. I discovered that I could combined my teaching skills and my computer knowledge to help people put technology to use to solve practical problems, which led to my writing for PC Magazine as a Contributing Editor for more than 20 years.
I have since gone on to cover other technology topics, and for the past five years, I have concentrated on health technology. I am the Editor of Health Tech Insider, a website that covers wearable and mobile devices for health and medical applications, along with supporting technologies.
Can you share the most interesting story that happened to you since you began leading your company?
I’ve had the opportunity to try all sorts of digital health tech devices, many of which are still in the developmental stage. While this is interesting, I think one highlight is the time that I was asked to be the Keynote Speaker and Honorary Program Chair for The Digital Health Conference in Melbourne, Australia. The experience gave me the opportunity to talk with people from around the globe, and see firsthand that many of the healthcare issues that we face are universal.
Can you tell our readers a bit about why you are an authority in the healthcare field?
My publication gives me access to C-level executives of major corporations, such as Samsung, Philips, and CIGNA, as well as the opportunity to meet founders of small startups and researchers from university labs. This gives me a perspective on the health tech industry that few people have. I like to describe it as most people in health tech companies are busy working in their foxholes, developing their products and growing their business. I have the luxury of floating above, looking into many of these foxholes at once, giving me broad insights into the current state of the industry and where it might be headed next.
What makes your company stand out? Can you share a story?
There are other publications that cover technology in general. There are also publications that cover devices and other information for professional medical audiences. But there are few other publications — if any — that cover the health tech industry the way that we do. It is gratifying to walk around the exhibit halls at CES every year, and meet with top executives from large companies who will remark unprompted that the weekly Health Tech Insider newsletter is on their must-read list.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
I see so many important shifts in healthcare as a result of technology. One important change is the fitness trackers market shifting from consumer to enterprise. When a consumer buys a fitness band, it costs them money. When a large employer or insurance company or healthcare service buys 1,000 or 10,000 trackers for their employees/clients/patients, they see a real return on their investment that can be worth millions of dollars a year. One sign of this is that Fitbit’s most recent models were initially released only for corporate customers.
We’re also seeing the benefits of the “the quantified self” in healthcare. No longer are we just collecting data; artificial intelligence and big data analytics are turning this mass of numbers into actionable information. And we can see that healthcare systems are catching on. The recent American Heart Association guidelines for measuring blood pressure call for multiple readings, ideally not in a clinical setting but rather in the patient’s home. Connected devices are making this easier for both patient and physician.
And remote patient monitoring is just one part of telehealth that is making healthcare more accessible. Telehealth makes it possible to shift both time and space for both patient and physician, giving patients easier access to needed healthcare resources. This is not just a problem for sparsely populated areas such as the southwest parts of this country; it’s also a problem in Brooklyn. For the elderly or people of limited means, getting time off work, arranging for transportation, and enlisting the help of a companion can place enormous obstacles in the way of getting to a hospital or doctor’s office. Remote monitoring can identify illness earlier so that treatment can start sooner, resulting in fewer complications, better outcomes, and lower costs.
Are you working on any exciting new projects now? How do you think that will help people?
I’m developing a program to help companies plan and initiate employee exercise and wellness incentive programs, showing executives and managers that they can realize a significant return on investment in the form of reduced healthcare costs, while also improving productivity, engagement, and retention.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
I’ve seen lots of technology startups over the years and have learned a number of key points that can determine success or failure.
1. Build what people want. Too many companies focus on what they think people need, and then have trouble selling it. You can give them what they need, but you have to also make sure that they want it.
2. Have a plan. Too many companies start with a vision, but not a full understanding of all the parts it will take to get there. You need the full package, from the technology to the market understanding, from funding to a clear supply chain.
3. Whatever you are planning to do will take twice as long and cost twice as much as you think it will. To be safe, double those numbers again.
4. Know the market and the competition. Are you inventing something that has already been done? If nobody else is selling what you plan to make, it may be because there’s no market for it. Do your research.
5. Don’t try to do it all. Rent the skills and knowledge that you don’t have. There are plenty of companies out there that can help with engineering or testing or packaging or whatever other skills you lack. Understand that they can solve many of your problems much faster, which will help you get to market sooner.
Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
We have access to some of the most amazing medical technology in the world, but technology alone is not the answer. You need a sustainable system.
Our healthcare system does not work well in sparsely populated regions. Our rural hospitals are closing at an alarming rate. And efforts that may increase the numbers of uninsured patients are likely to accelerate this effort. Patients will show up in emergency departments, and will have to be treated at the hospital’s expense. We need more options that will give people affordable access to non-acute healthcare services.
Hospitals have enormous overhead, making individual services expensive. The $100 aspirin doesn’t cost $100, but when you parcel out all the physical plant, employee, compliance, and insurance costs, it rapidly gets expensive. Having other, leaner options available with less overhead will help keep costs down.
As a nation, we seem take the attitude that if we make unhealthy choices, someone can fix it for us. We need to continue the shift to a “wellness” attitude, with feedback systems that reward individuals and healthcare systems for helping people to be healthy, rather than wait to “fix” them when they get sick.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
1. I’d encourage more states to pass laws that encourage telemedicine. 34 states passed new laws in this area in 2017 (https://mhealthintelligence.com/news/2017-a-look-back-at-the-year-in-state-telemedicine-legislation) but a lot of restrictions still persist. And since medical services are regulated at the state level — such as licensing — this cannot be done at the federal level. Note that the Veterans Administration has done a great deal to expand the use of telehealth technology (https://www.telehealth.va.gov/) but much more remains to be done.
2. Rapidly expand remote patient monitoring services, not just for post-discharge situations, but to help monitor healthy individuals. Once-a-year “wellness” visits are inadequate — if they happen at all — and I believe that healthcare costs can be reduced by earlier detection and treatment of illness.
3. Make great use of cognitive behavioral therapy (CBT) and gamification technology to encourage healthier choices. If we can make Facebook so persistently addictive, we should be able to create apps and other technology that engage individuals and encourage them to make better lifestyle choices.
4. Push to test wearable devices for accuracy and reliability. When people were just using fitness trackers to count steps, a 20% error rate was frustrating but not critical. Now that we’re using the data for health and medical decisions, accuracy can be a matter of life and death.
5. Honestly evaluate connected devices for their impact on healthcare costs. While many help reduce costs, some classes of devices (such as infant monitors) can increase the number of unnecessary office and emergency department visits, thus pushing healthcare costs higher with no gain in better outcomes.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
Encourage your company to offer wellness screening and employee fitness incentive programs. These are proven to have a significant return on investment (as much as 600% in some cases) and can put a significant dent in healthcare costs.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
My favorite book continues to be “Small Is Beautiful” by E. F. Schumacher. While it has little to do directly with health tech and it’s nearly 50 years old, it describes a way of thinking about technology and how to apply it that remains relevant today. Bigger is not always better, and Schumacher shows how small-scale solutions can sometimes out-perform.
As for something more contemporary, I am fortunate to count Nick van Terheyden, MD (“Dr. Nick, the Incrementalist”) as a friend and colleague. .He has well-informed and disruptive views about healthcare in this country and worldwide, and he’s very entertaining in his writing and his speaking.
How can our readers follow you on social media?
Thank you so much for these insights! This was so inspiring!